Patients exhibit multiple cognitive and behavioral symptoms upon entering the earliest stages of dementia, but these external signs are not the only indications that a physician uses to determine a patient's mental health. Signs accruing and developing inside the brain are more significant, and may help to make a more formal determination of the type of dementia affecting the patient. Brain imaging, such as MRI or PET scans, can reveal these signs and contribute to a more accurate diagnosis.

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Brain Imaging Can Aid Professionals

In most cases, brain imaging can assist professionals in diagnosing dementia, ruling out other possibilities with similar symptoms and verifying which stage a patient may be experiencing. Using scans to analyze signs of dementia can exclude the possibility of lesions that cause cognitive degeneration or impairment (such as a tumor, an abscess, or a subdural hematoma).

It can also help to determine which kind of dementia a patient is experiencing. For instance, vascular dementia may not show evidence of a cortical loss, whereas this qualifier could still allow a patient to have Alzheimer's disease. Also, by undergoing frequent scans, neurologists can make a determination of how the disease is progressing. If a diagnosis is uncertain, follow-up scans taken after a few years can prove that degeneration is occurring. Finally, brain imaging can assist researchers in determining how each disease can affect a patient, and whether certain treatments are effective.

Structural Signs Of Dementia

Structural imaging of the brain consists of computed tomography (CT) and the popularly known magnetic resonance imaging (MRI) scans. This kind of imaging focuses on the morphology as well as the structural details of the brain's composition. It is a very physical kind of scan, searching for solid, visible signs of degeneration or abnormalities.

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Degenerative dementia causes a number of visible physical signs in the brain in some patients, but is not always easy to detect. CT scans can usually observe some atrophy of the brain's medial temporal lobe, but the CT scans' lack of sensitivity can occasionally be problematic. MRI scans, of much higher resolution, can capture atrophy of the hippocampus in nearly 90 percent of all cases of Alzheimer's disease.

Functional Signs Of Dementia

Functional imaging of the brain can include a functional MRI, a positron emission tomography (PET), or a single photon emission computed tomography (SPECT) scan. This kind of imaging serves as a complement to structural imaging, focusing on the underlying brain chemistry and activity rather than its physical composition.

SPECT and PET are similar kinds of scans, and in most cases of degenerative dementia, can showcase bilateral, biparietal, and bitemporal hyperperfusion. Some ligand compounds (when utilized as part of the scan) can reveal the impaired integrity of presynaptic dopamine transporters, present both in degenerative dementias and Parkinson's disease.

The external signs of dementia can often be mistaken for those of another condition, but neural imaging can analyze the internal signs of the disease and help draw a firmer conclusion about a patient's specific condition, and the progression of that condition.